Responding to Emergency Conditions

Emergency Conditions

Responding to...

Chest Pain

About Chest Pain

Heart attacks, heartburn and indigestion, and chest muscle pain—all different types of chest pain. The conditions can range from minor to life threatening. Can you tell the difference?

In this section, we’ll take a close look at some of the most common forms of chest pain, symptoms, home treatments, and most importantly when to see a doctor.

First Things First

Call 911 or emergency personnel if you believe that you may be suffering from a heart attack. It’s far better to be safe than sorry! The most common signs and symptoms are located in this section.

Signs & Symptoms

When it comes to chest pain, there are clear signs and symptoms that are serious and should be heeded.

If present, these serious signs and symptoms may indicate heart attack, pulmonary em-bolism, or angina. The major symptoms of each are outlined below.

Serious Conditions

If you are experiencing any of the symptoms outlined below, it could be the sign of a se-rious heart condition. Seek medical care or call 911!

Symptoms of Heart Attack/Angina

Heart attack is an interruption of blood supply to the heart. Angina is a lack of enough oxygen to the heart.

A burning, crushing, and/or squeezing pain or pressure in the chest

Pain in the arms, neck, back, and/or jaw

Pain unrelieved by rest or lasting longer than a few minutes

Irregular pulse or palpitations

Nausea, vomiting, shortness of breath, dizziness, weakness, sweating

Patients with diabetes and women are more likely to present with unusual, atypical complaints without classic symptoms

Signals of a Heart Attack can develop in either sex, any age or any place

Symptoms of Pulmonary Embolism

A pulmonary embolism is a blood clot in the lung.

Chest pain with sudden shortness of breath

Pain in breathing, especially deep breathing

Anxiety, fear, or a sense of impending doom

A rapid heartbeat

A Word of Caution

There are other signs and symptoms that can be indicative of a serious heart condition. Oftentimes the signs and symptoms of a serious heart condition may be mistaken for indigestion, heartburn, or chest muscle pain. In this situation, it’s always better to be safe than sorry. Use the decision tree on this page to help you better understand the severity of the situation. The decision tree will help you better understand what to do.

An Emergency Essential

Act Right Away! If you or someone you know is experiencing chest discomfort or any symptoms of a heart attack, you must act immediately. According to the American Heart Association, you should call 911 within five minutes if you are experiencing the symptoms of a heart attack. When it comes to reacting to a heart attack, early care can save your life.

When to Seek Care

When serious chest pain strikes, we rarely have the opportunity to look for helpful health literature to guide us. That’s why it’s paramount that you spend some time with this decision tree right now. Make sure you’re familiar with the signs and symptoms of serious chest pain.

If the unfortunate should happen, you’ll be prepared and know what to do right away—this could save a life.

1. Do one or more of the following accompany your chest pain?

Radiating pain through the arm, neck, or jaw

Perspiration

Difficulty breathing or shortness of breath

Irregular heartbeat or pulse

Vomiting or nausea

Sense of doom

Yes — Call 911

2. Did a serious injury induce your chest pain?Yes — Call 911

3. Is your chest pain associated with a recent operation or illness that has kept you in bed?Yes — Call 911

4. Do you have a history of heart problems?Yes — Call 911

If you answered yes to any of these questions, call 911 immediately. There’s more information on chest pain on the following pages.

“If CPR is not provided, a person’s chances of surviving a heart attack decrease by seven to 10 percent with every minute that passes.”

Treating Minor Conditions

If you’re experiencing any of the symptoms of a serious heart condition, home treatment is not an option—call 911 immediately!

If, however, you’re experiencing symptoms of a less serious condition (like heart-burn/indigestion or chest muscle pain) there are a number of things you can do at home, and without the help of a physician, to feel better.

Sharp or stabbing pain that can be localized by the tip of a finger and reproduced by pushing on the spot is rarely cardiac in origin.

Chest Muscle Pain

Take an over-the-counter pain reliever such as ibuprofen or acetaminophen—heed allergies or other medical conditions.

Apply heat (heating pad or water bottle) to the affected area.

Apply a medicated rub such as Flexall.

Avoid activity which may further strain your chest muscles.

Frequently Asked Questions

How do I know if I’m having a heart attack?

The most common symptoms associated with a heart attack include: a burning, crushing, and/or squeezing pain or pressure in the chest; pain in the arms, neck, back, and/or jaw; or pain that doesn’t go away or lasts longer than 15 minutes—check out the signs and symptoms on the previous pages.

Are heart attacks preventable?

By exercising regularly, eating a balanced diet, and avoiding all tobacco products, you greatly reduce your chances of suffering a heart attack. And while there are no guarantees, following these three simple guidelines will give you a much better chance of maintaining a healthy heart throughout the years.

What are the risk factors for heart disease?

The risk factors for heart disease include cigarette smoking, a family history of heart disease, high cholesterol, high blood pressure, and living a sedentary lifestyle.

What are my chances of dying from a heart attack?

Each year nearly 1.1 million Americans experience a heart attack, and another 3 million patients are hospitalized each year for chest pain. Of those Americans who suffer a heart attack, each year, about half die. But here’s the good news—studies show that 75 percent of people survive heart attacks with little or no heart damage if they seek help within 60 to 70 minutes of the onset of symptoms.

Preventing Heart Attacks & Heart Disease

Whether you currently suffer from chest pains or want to avoid them altogether, there are some important steps you should take now to prevent serious heart conditions in the future. Check out these steps below, and take action now.

Before you begin your prevention program, see your healthcare professional for a complete physical to ensure a clean bill of health.

Upon approval, exercise at least 30 minutes most days of the week.

Eat a well-balanced, low-fat diet.

Don’t smoke and avoid second-hand smoke.

Reduce your level of stress.

Have your blood pressure and cholesterol checked regularly.

Become familiar with your family’s history of heart disease.

Aspirin...More Powerful Than You Think

Research has shown that aspirin is beneficial in the prevention and management of major heart problems. Daily dosage typically ranges from 75mg to 325mg, but it’s rec-ommended that a healthcare professional determine each individual’s correct dose. Here’s the rest of the story.

Aspirin Before

The use of aspirin on a regular basis to prevent an initial heart attack or other heart conditions has proven to be effective. However, since aspirin is not without risk in certain individuals, this prevention option should be discussed with a healthcare professional.

Aspirin During

Research has shown that taking an aspirin during a heart attack (as long as the individual is not allergic) will significantly enhance their chance of survival.

Aspirin After

The use of aspirin is also effective as a form of secondary prevention. In fact, taking aspirin has been shown to prevent the reoccurrence of heart attacks and angina.

In all instances, consult a healthcare professional to ensure your safety when using aspirin to prevent heart disease. The decision is between you and your healthcare pro-vider—together you can decide whether or not to make aspirin a part of your daily pre-vention schedule.

An Important Tip on Aspirin

If you are taking aspirin to protect your heart, don’t take ibuprofen (e.g., Motrin or Advil) or naproxen (such as Aleve) frequently, because these substances can block the anti-clotting effect of aspirin. It’s OK to take ibuprofen or naproxen on occasion, but don’t take these substances during the few hours before the aspirin.

“Approximately 3 million patients are hospitalized each year for chest pain.”

Cuts, Scrapes & Punctures

About Cuts, Scrapes, & Punctures

Minor cuts, scrapes, and punctures are common injuries that we experience from time to time. While the vast majority of these injuries can easily be handled at home, some are potentially serious, warranting medical attention. The first step in treating one of these injuries is to identify the type of injury you have.

Cuts. A cut slices the skin and is also referred to as a laceration.

Scrapes. Scrapes (abrasion) occur when several layers of skin are removed as a result of brushing against an abrasive surface. These injuries tend to be somewhat painful as nerve endings are exposed.

Punctures. Puncture wounds leave holes in the skin and are usually caused by sharp objects penetrating the skin.

When to Seek Care

In some cases, a cut, scrape, or puncture may be serious enough that it requires medical attention. If you experience any of the following, seek medical assistance.

If the wound appears to be serious and is to the head, neck, chest, abdomen, or face, or a serious hand wound

If the victim is showing signs of shock (pale, gray, or cool skin; weak or rapid pulse; slow or shallow breathing; or nausea and vomiting)

If bleeding cannot be controlled

If there is tingling or numbness at the wound site

If the individual is unable to move fingers or toes

If the wound exhibits signs of infection (oozing puss, turning red, swelling, or a fever develops)

If the victim has not had a tetanus shot within the last 10 years

An Emergency Essential

The Right Way to Control Bleeding. When applying pressure to a cut, scrape, or puncture to stop the bleeding, DO NOT remove the bandage if it becomes saturated with blood. Simply apply a new bandage on top of the saturated one, and continue to apply pressure to stop the bleeding. Change the bandage only after the bleeding has stopped.

Home Treatment

Many cuts, scrapes, and punctures can be treated easily at home. The exception, how-ever, are those accompanied by uncontrollable bleeding, numbness, an inability to move extremities, and the signs mentioned on the previous page.

Treat cuts, scrapes, and punctures with self-care using the following simple steps. Try over-the-counter pain relievers like acetaminophen or ibuprofen to ease your pain—heed allergies or other medical conditions.

Cuts

Stop the bleeding by applying direct pressure to the wound. Most bleeding should stop within a few minutes if direct pressure is applied to the wound. If a wound bleeds profusely for more than four to five minutes, call 911.

For minor cuts, cleanse the wound vigorously with soap and water.

Consider using an antibiotic ointment to prevent infection.

Apply a bandage to the wound. Bandages should be changed daily.

Use over-the-counter medications like ibuprofen or acetaminophen to ease your pain.

Contact your healthcare professional to determine if a tetanus shot is needed. If it has been longer than 10 years since a tetanus shot was administered, or if you have experienced a serious injury in the last five years, you’ll probably need another tetanus shot.

“If a wound bleeds profusely for more than four to five minutes, call 911.”

Bites & Stings

About Bites & Stings

In some cases bites and stings can be serious and deserving of immediate attention. The information in this section will help you determine what to do in reacting to a bite or sting.

Signs & Symptoms

Symptoms of bites and stings are easy to recognize. They include:

Insect/Spider Bites and Stings

At the site of the bite:

Itching or swelling

Small, raised, red bump(s)

Heat or a burning sensation

Animal Bites

Punctures and/or tearing of the skin

Bleeding—light to severe depending on the bite

Underlying tissue damage

Bruising/crushing may be present if the bite is from livestock or a wild animal.

When to Seek Care

It’s important to contact a healthcare professional—perhaps including a call to 911—if any of the following signs or symptoms are present.

If there is profuse bleeding that won’t stop after four to five minutes of direct pressure.

If the bite was caused by a black widow, brown recluse, or other poisonous spider. Black widows are glossy black spiders with a red or yellow hourglass shape on the stomach. Brown recluse spiders are small brown spiders with long legs and a violin-shaped pattern on the back.

If you are bitten by an animal you suspect may have rabies (animal is foaming at the mouth or unusually aggressive).

If signs of infection are present (oozing puss, turning red, fever, and swelling).

If the bite is from a bat or other wild animal, or from a pet whose owner cannot be located to determine if the animal has been vaccinated for rabies.

An Emergency Essential

Wear Your Bracelet. Any person severely allergic to bites or stings should always wear a medic alert bracelet so that emergency medical personnel are aware of the allergy. For more information on allergy bracelets visit Medic Alert at www.medic alert.org.

Home Treatment

For an insect, spider, or animal bite or sting, cleaning, bandaging, and keeping a close eye on the wound for infection is usually all that is required. Follow the home treatment advice below for a typical bite or sting.

Insect/Spider Bites and Stings

Inspect and clean the wound carefully (if there is a stinger present, remove it without squeezing it to avoid the release of more venom into the blood stream).

Apply an ice pack to an insect bite or sting to reduce swelling and pain. Do not apply ice directly to the affected area—use an ice bag instead.

Try an over-the-counter medication to relieve swelling, itching, and discomfort. An oral antihistamine may help reduce itching and redness, and an anesthetic spray like Solarcane can help relieve pain. Hydrocortisone or calamine lotion may be helpful as well.

Animal/Human Bites

Allow the wound to bleed for a few minutes to clean itself out (DO NOT allow the wound to bleed if there has been a large loss of blood, or if blood is spurting out—Contact a healthcare professional IN THIS CASE).

Determine whether or not stitches are needed. Stitches may be needed for bites deeper than a quarter inch, those that gape open, or bites that continue to bleed after four to five minutes of direct pressure.

If no stitches are needed, clean and bandage the wound and use an over-the-counter pain reliever such as acetaminophen or ibuprofen to relieve pain.

Replace the bandage daily.

“Insect allergies are most frequent after being stung by a bee, wasp, yellow jacket, hornet, or fire ant.”

Burns

About Burns

Minor household burns are common in America, and can result from contact with a hot surface, steam, chemicals, electricity, or even friction. Fortunately, most burns are pre-ventable and easily treated at home. However, there are those that require more medical attention.

The first step in treating a burn is to determine what degree of burn has occurred. This is done by observing the depth of the burn. Different degrees of burns will exhibit different signs and symptoms.

Signs & Symptoms

First-Degree Burns (superficial). A first-degree burn affects only the outer layer of skin, and is generally treatable using self-care remedies. The skin will be dry, red, and painful to the touch. A sunburn is a good example of a first-degree burn.

Third-Degree Burns (full thickness). Third-degree burns involve all layers of the skin, and may damage underlying tissue and organs. These burns are often less painful be-cause nerves have been destroyed. The skin may be charred black, or may have a dry, white, or yellowish appearance.

When to Seek Care

Severe burns require the attention of a medical professional. Contact a healthcare professional in the following situations.

If you determine that a second-degree burn covers 20 percent or more of your body

If you have a third-degree burn

If the burn is deep or painful, or on the face, hands, feet, or genitals

If the burn involves a child, elderly person, pregnant person, or someone with a de-pressed immune system

If a strong chemical like acid or lye caused the burn or is splashed in the eye

If signs of infection are present (heat or red streaks extending away from the wound, liquid discharge, or fever, swelling, redness, or tenderness)

An Emergency Essential

Leave Blisters Alone. Burn blisters should not be popped, squeezed, or otherwise tampered with as they provide an element of protection against infection. Resist the urge to pop blisters and let the burn heal on its own.

Treating Burns

Many first-degree burns, and some second-degree burns, can be treated at home, while third-degree burns require the immediate attention of a healthcare provider. If you’ve determined that you have a first-degree burn or manageable second-degree burn, you may treat it in the following ways.

First-Degree Burns

Move away from the heat source— stop the burning process.

Flush the burned area with cool water; do not use ice or ice water on a burn as it can cause tissue damage.

Apply a local anesthetic like Solarcane or take an over-the-counter pain reliever such as ibuprofen or acetaminophen—heed allergies or other medical conditions.

Second-Degree Burns

Move away from the heat source—stop the burning process.

Flush the burned area with cool water; do not use ice or ice water on a burn as it can damage tissue.

Remove restrictive jewelry and clothing to allow for swelling.

Wash the wound with mild soap and water; make sure your hands are clean as second-degree burns are easily infected. Pat the wound dry with a clean cloth.

Dress the wound with a dry, sterile dressing. Change the dressing daily to avoid infection.

Third-Degree Burns

Seek immediate medical attention if you suspect you have suffered a third-degree burn—call 911.

It is recommended that burns be dressed with dry, sterile bandages, and that bandages be changed daily to help prevent infection.

Sunburns can be serious. Protect your children from sunburns by using a sunscreen with a minimum SPF of 15. Try to keep them out of the sun as much as possible during peak hours (10 AM to 4 PM).

“Third-degree burns—those that may appear charred, dry, white, or yellowish—should always be evaluated by a medical professional. Call 911 immediately.”

Head Injuries

About Head Injuries

Minor head injuries, such as bumps and bruises or cuts and scrapes, are part of everyday life for many people. Every head injury should be viewed with caution. Use the in-formation in this section to determine what form of care is most appropriate.

Signs & Symptoms

Because most minor head injuries are typically caused by bumps, cuts, or scrapes, the most common symptoms include:

Localized pain surrounding the injured area

Bleeding—because there are many blood vessels located near the surface of the skin on the head, minor head wounds often bleed more than similar wounds in other parts of the body.

A short-lived ache after bumping one’s head

When to Seek Care

While some head injuries can be treated effectively at home, there are, however, several conditions including concussions, blood clots, or skull fractures, which demand immediate medical attention. If you suspect a victim has also suffered a spinal or neck injury, do not move the person—it may cause further injury. Seek medical attention in the following situations.

If the victim is or was unconscious as a result of their injury

If bleeding is severe or cannot be controlled after four to five minutes of direct pressure

If the victim’s breathing was interrupted for more than 30 seconds

If the victim experiences seizures

If the victim seems confused, sleepy, or has slurred speech (possible signs of a serious head injury)

If the victim shows signs of shock (pale, gray, or cool skin; weak or rapid pulse; slow or shallow breathing; or nausea and vomiting).

If the victim is unable to move, or has difficulty moving a part of the body that was not injured.

If there is severe pain in the victim’s neck or back, or if the victim is experiencing a tingling sensation and/or numbness in their extremities (possible signs of a spinal injury).

An Emergency Essential

Put A Lid On It. Perhaps the most important thing you can do to protect your head from injury is to wear a helmet. Whether riding a motorcycle, a bicycle, or engaging in any other recreational activity, always wear a helmet—the extra effort is worth the benefit.

Home Treatment

If you’ve experienced a minor head injury, use the following self-care treatments.

If bleeding occurs, thoroughly clean the wound and control bleeding. Bleeding should stop within four to five minutes.

Apply an ice pack to the injured area to reduce swelling or bruising (do not apply ice directly to the skin, instead, use an ice bag).

Clean minor cuts and scrapes thoroughly—you may wish to apply an antibiotic ointment such as Neosporin to prevent infection.

Cover the wound with a sterile bandage to keep it clean. Change bandage daily.

Take an over-the-counter medication such as acetaminophen or ibuprofen to relieve a mild ache associated with a bumped head.

Get plenty of rest.

Unconsciousness

Emergency situations that involve a loss of consciousness are always serious. And be-cause the causes of unconsciousness include heart attack, head injury, stroke, diabetes, or shock—just to name a few—an unconscious person always needs immediate medical attention. The following will help you treat an unconscious victim.

Call 911 immediately if the victim is unconscious, not breathing, or has no pulse.

If the victim is not breathing, but has a pulse, begin rescue breathing.

If the victim is not breathing and doesn’t have a pulse, begin CPR. CPR should only be performed on an individual who DOES NOT have a pulse or who shows no signs of circulation.

Treat any injuries that you can, but minimize body movement to prevent further injury.

Keep the person lying down on his or her side.

DO NOT give the person anything to eat or drink.

“More than 1.2 million Americans sustain head injuries annually.”

Heat-Related Illnesses

About Heat-Related Illnesses

Most heat-related illnesses, such as heat exhaustion or heat rash, are common conditions associated with rising body temperatures and overexertion in warm temperatures. Often, victims of heat-related illnesses have been working outside in high temperatures, are dehydrated, or are possibly elderly, very young, or suffer from chronic conditions such as diabetes.

Though most heat-related illnesses do not require professional medical assistance, some, such as heat stroke, are very serious and potentially life threatening. In this section we’ll take a look at the two most common heat-related illnesses: heat exhaustion and heat stroke.

Signs & Symptoms

Heat Exhaustion

Heat exhaustion is typically the result of dehydration through perspiration in warm tem-peratures. Symptoms will include:

Excessive sweating

Headache or nausea and vomiting

Cold, moist, or pale skin

General fatigue

Heat Stroke

Heat exhaustion can lead to heat stroke—a potentially life-threatening medical condition. Heat stroke occurs when a person’s body is unable to keep itself cool, leading to body temperatures as high as, or exceeding, 105°F. There is no home treatment for heat stroke. If a person shows signs of heat stroke, seek medical assistance immediately—call 911. Symptoms of heat stroke include:

Absence of sweating

Unconsciousness, confusion, or dementia

Rapid, shallow breathing

Hot, red, and/or dry skin

Rapid pulse

When to Seek Care

Heat stroke, when untreated, causes a person’s core body temperature to rise to or ex-ceed temperatures as high as 105°F. Such high temperatures can prevent a victim’s organs from functioning properly, leading to death. If you suspect someone is suffering from heat stroke, seek professional medical assistance immediately. Seek immediate medical assistance in the following situations.

If the person’s body temperature has reached or exceeded 102°F

If the person’s pulse is either rapid or weak

If the person is or was unconscious or greatly confused

If the person’s breathing has become rapid or shallow

If the person has stopped sweating altogether, and their skin has become hot, red, and dry

If the person’s pupils are dilated

An Emergency Essential

Get Enough Water. If you are doing strenuous activity outside during hot weather, drink two to four glasses (16 to 32 ounces each) of cool fluids each hour. Avoid alcoholic beverages, they will dehydrate you.

Home Treatment

Some cases of heat exhaustion can be treated at home. If, however, the victim exhibits any signs of heat stroke, seek medical assistance immediately. To care for a person suffering from mild heat exhaustion, follow the guidelines below.

Heat Exhaustion

Move the person out of the sun and into a cool, dry place.

Loosen the person’s clothing, and give them a sponge bath with cool water (do not immerse the person in an ice bath or cold water).

Re-hydrate the person by giving them fluids immediately, and over the course of the next 24 hours.

Monitor for signs of heat stroke. If the person does not begin to feel better after 15 to 20 minutes or begins to show signs of heat stroke, seek medical assistance immediately.

Heat Stroke

There is no home treatment for heat stroke. If a person shows signs of heat stroke, seek medical assistance immediately—call 911.

Prevention

As mentioned earlier, heat-related illnesses are, indeed, common conditions. But the fact is, they don’t have to be. By taking the following precautions, especially when working outside in high temperatures, your time in the sun will be much more safe.

Drink plenty of fluids—eight, 8oz. glasses of water daily, and more with increased physical activity and higher outside temperatures.

Schedule outdoor events during cooler times of the day or year if possible.

When working outside, take frequent rest breaks out of the sun to cool your body.

Eat fruits and vegetables to replace lost vitamins and minerals.

“Between 1979 and 1999, more people died from heat-related illness than died from hurricanes, lightning, tornados, floods, and earthquakes combined.”

Take The Self-Care Quiz

The quiz below is designed to test your knowledge on the information presented in this section. Use this quiz as a tool to better understand how to care for yourself and others.

True False — If a person demonstrates the signs and symptoms of a heart attack, 911 should be called immediately.

True False — It’s OK for cuts, scrapes, and punctures to bleed for longer than four to five minutes.

True False — Ice should be applied directly to burn injuries.

True False — 911 should always be called when a person is or was unconscious as a result of a head injury.

True False — A person suffering from heat stroke can be treated using simple self-care.

Managing Your Own Health and Seeking Medical Care

The information contained in this guide is based on the best health information available and has been reviewed for accuracy. This information is not intended to replace the advice of your healthcare provider. If you have any questions about managing your own health and/or seeking medical care, please contact a medical professional.